Routine inspection·October 18, 2024

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met Administrator Liubov Shevtsova at approximately 8:15 AM and explained reason for visit. The facility is a one-story home located in a residential area. It is licensed to serve (6) elderly residents, ages 60 and over, of which (5) may be non-ambulatory, (1) may be bedridden, and has a hospice waiver approved for (3). The home consists of a living room, kitchen, dining room, (4) resident bedrooms, (2) resident bathrooms, (1) staff bedroom, a shaded patio in the backyard with seating, and an attached garage. LPA toured the facility and observed the following: Each client bedroom has the required furniture and bedding. There is extra clean linen and towels in a hallway closet. Smoke detectors were observed in each room and throughout the facility and are properly operating. There is 1 carbon monoxide in the hallway and is properly operating. The facility has one (1) fully charged fire extinguishers which is kept in the kitchen. Cleaning supplies and toxic substances were observed to be accessible to clients in cabinet next to dining room deficiency cited. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 45 degrees F. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. Sharps are locked and placed in cabinet in kitchen. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. The shower accommodates non-ambulatory residents and has the required grab-bars and non-skid mat. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents located in the backyard. Passageways and exits are free of obstruction. The garage is clean and has extra supplies. SEE LIC 809C Four (4) Staff files were reviewed and included Criminal clearance record, CPR/training, and health screening with TB. Three (3) Client files were reviewed and included physicians report, TB clearance. Fire/earthquake drill was conducted in April 2024 TV was given. Infectious control plan was reviewed. The medications are centrally stored and locked in a cabinet in kitchen The facility uses the Medication. LPA reviewed medications for all clients, and they are being administered as prescribed by the physician. Deficiencies have been noted on LIC 809D under Title 22 Regulations. Exit interview was conducted and a copy of this report, LIC 809D and appeal rights were provided.